[Torsion of a nongravid leiomyomatous uterus]

The torsion of a nongravid uterus is not of frequent occurence. The leading reasons are a presence of an adnexial formation or leiomyomas. In this case report it has been presented a 65-year old patient with a hard abdominal pain. After the gynecologic and ultrasound examination it has been found an uterus myomatosus with three intramural-subseros leiomyomas. By the following laparotomy was confirmed the ultrasound results - the uterus with big intramural-subserous leiomyoma 8-9 cm in a diameter, and two more leiomyomas - 5 cm, a torsion of the body uterus at 180 degree above the vaginal part of the cervix. The adnexes were rotated around the supravaginal (isthmic) part of the uterus, the uterine tubes were hyperemic, swollen, with livid color, and the ovarian were atrophic. Total hysterectomy with bilateral adnexectomy was performed. We suggested that the main reason for this torsion of the uterus was the presence of leiomyomas and the genital descensus played a role as a predisposition.